BACKGROUND:On the basis of thorough debridement, homochronous anterior or staging posterior fixation has been a standard scheme for spinal tuberculosis. Numerous studies confirmed that above approach has obtained good effects, but the anterior approach has some disadvantages, such as complex anatomic structure, great trauma, relatively more complications, and difficult operation and fixator implantation. OBJECTIVE:To observe spinal stabilization and deformity correction in patients with single-segment thoracic/lumbar spinal tuberculosis after posterior debridement and interbody fusion. METHODS:Clinical data of 36 patients with single-segment thoracic/lumbar spinal tuberculosis undergoing one-stage posterior debridement and interbody fusion in the Guangxi Yulin Orthopedics Hospital of Integrated Traditional Chinese and Western Medicine from January 2008 to January 2012 were retrospectively analyzed. There were 2 cases in single T11/12 segment, 4 in T12/L1 segments, 6 in L3/4 segments, 22 in L4/5segments and 2 in L5/S1 segments. Of them, 24 patients suffered from different degrees of spinal nerve injury. At 6, 12 and 24 months after surgery, al patients were folowed up. Bone graft fusion, kyphosis correction, functional recovery of the spinal cord and complications were observed. RESULTS AND CONCLUSION:Al patients were folowed up for 24-38 months. Cobb angle of kyphosis and spinal stenosis rate were significantly improved at 2 years after treatment (P < 0.05). The lumbar back pain symptoms were significantly improved in final folow-up (P < 0.05), with an intervertebral fusion rate of 100%. No lesion residue and recurrence, correction loss, fixation loosening or displacement was found. These results demonstrated that in patients with single-segment thoracic/lumbar spinal tuberculosis, posterior debridement and interbody fusion can effectively reconstruct spinal stabilization, correct deformity, and promote the functional recovery of spinal nerves.

Objective To investigate the value of prognosis of NT-proBNP in severe sepsis and septic shock patients .Methods 70 patients with sepsis admitted to our hospital were divided into general sepsis group (n=23) ,severe sepsis group(n=28) and sep-tic shock group(n=19) according to the severity of the disease ,the plasma NT-proBNP ,lactic acid ,C-reactive protein were meas-ured within 1 h after admission ,and calculated the 24 h acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) .Results (1) Plasma NT-proBNP concentration ,lactic acid ,CRP and APACHE Ⅱ score in severe sepsis group ,septic shock group was sig-nificantly higher than that of general sepsis group(P< 0 .05);Plasma NT-proBNP concentration ,CRP and APACHE Ⅱ score in septic shock group was significantly higher than severe sepsis group (P<0 .05) .(2)70 cases of patients with sepsis with 15 cases died and 55 cases survived .Plasma NT-proBNP concentration ,lactate ,CRP and APACHEⅡscore of death patients was significantly higher than the survival patients(P<0 .01) .(3) Plasma NT-proBNP concentration at the time of sepsis patients admitted to hospi-tal with positively correlated to APACHE Ⅱscores(r=0 .528 ,P<0 .01) .Conclusion The plasma NT-proBNP is closely related to the prognosis of patients with sepsis ,early detection of plasma concentration of NT-proBNP helps to evaluate the prognosis of pa-tients w ith sepsis .

Objective To explore the value of plasma procalcitonin (PCT)detection in dif-ferentiation and judgment of severe pyemia.Methods 70 patients with pyemia were divided into general pyemia group (n =23),severe pyemia group (n =28)and pyemia shock group (n =19), and plasma PCT,lactic acid,c-reactive protein,the acute physiology and chronic health evaluationⅡ 24 hours (APACHE Ⅱ)and 1,2,3 days in hospital as well as serum PCT,lactic acid,c-reac-tive protein were detected and compared.Results Plasma PCT,lactic acid,CRP and APACHE Ⅱscore of pyemia shock patients were significantly higher than the general pyemia group (P <0.05). Serum PCT,CRP and APACHE Ⅱ score of pyemia shock patients were significantly higher than that of severe pyemia group (P <0.05).15 patients with pyemia died,55 patients survived.72 hours plasma PCT,lactic acid,CRP and APACHE Ⅱ score in death group were significantly higher than the survival group (P < 0.01).When pyemia patients were admitted to hospital,PCT were positively correlated with APACHE Ⅱ scores (r =0.528,P <0.01).Conclusion PCT is superior to the current clinical application of CRP inflammatory response parameters,and it can be used as an early identification of systemic infection,judgment of pyemia severity and prognosis judgment in-dex.

Objective To explore the value of plasma procalcitonin (PCT)detection in dif-ferentiation and judgment of severe pyemia.Methods 70 patients with pyemia were divided into general pyemia group (n =23),severe pyemia group (n =28)and pyemia shock group (n =19), and plasma PCT,lactic acid,c-reactive protein,the acute physiology and chronic health evaluationⅡ 24 hours (APACHE Ⅱ)and 1,2,3 days in hospital as well as serum PCT,lactic acid,c-reac-tive protein were detected and compared.Results Plasma PCT,lactic acid,CRP and APACHE Ⅱscore of pyemia shock patients were significantly higher than the general pyemia group (P <0.05). Serum PCT,CRP and APACHE Ⅱ score of pyemia shock patients were significantly higher than that of severe pyemia group (P <0.05).15 patients with pyemia died,55 patients survived.72 hours plasma PCT,lactic acid,CRP and APACHE Ⅱ score in death group were significantly higher than the survival group (P < 0.01).When pyemia patients were admitted to hospital,PCT were positively correlated with APACHE Ⅱ scores (r =0.528,P <0.01).Conclusion PCT is superior to the current clinical application of CRP inflammatory response parameters,and it can be used as an early identification of systemic infection,judgment of pyemia severity and prognosis judgment in-dex.